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Updated: Nov 22, 2025

Problem-Solving Before Instruction PS-I: A Protocol for Assessment and Intervention in Students with Different Abilities
Published on: September 11, 2021
Competency assessment of an undergraduate program using a third-party, objective pre-post examination
Lawrence Fulton1, Cristian Lieneck2, Zo Ramamonjiarivelo2
1Department of Health Administration, 601 University Drive, Texas State University, San Marcos, TX, 78666, USA. lf25@txstate.edu.
Background:
Assessing competencies or program learning outcomes in educational programs is often a leadership challenge. This case study reports medical education program's efforts to document undergraduate competency attainment using a pre-post, third-party, objective testing service that allows for inter-university comparison, a testing service that is being adopted by some certification and accrediting bodies.
Methods:
Students completed a pre-test after program acceptance and a post-test at the end of the last didactic semester (1.5 years later) just prior to their required internships. Scores and subscores were evaluated using t-tests (Holm-adjusted p-values). MANOVA models of sub-competency difference scores were also evaluated.
Results:
Results indicate competency improvement for each of the 12 areas based on the n = 55 student sample, (p < .001 for all scores). These improvements were independent of ethnicity, age, gender, and grades. The average student improved by 12.85 points (95% CI of 10.52 to 15.18) with the largest improvements in strategic planning and leadership competency areas (21.30 and 18.33 percentage points, respectively).
Conclusions:
The third-party pre-post has some face validity given that student performance improved after completing a related curriculum as would be expected. Congruent with earlier studies, we find that repeated testing helps document competency attainment and that a single method for assessment is insufficient. We further document limitations of this 3d-party exam.
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